Necrotizing palupalu maʻi maʻiʻaʻai

ʻO ka maʻi necrotizing palupalu kahi ʻano laha ʻole akā koʻikoʻi loa ia o ka maʻi bacteria. Hiki iā ia ke luku i nā mākala, ka ʻili, a me nā aʻa i lalo. ʻO ka huaʻōlelo "necrotizing" pili i kekahi mea e make ai nā kino o ke kino.

Hiki i nā ʻano bacteria he nui ke kumu i kēia maʻi. ʻO kahi ʻano koʻikoʻi a make pinepine hoʻi o ka necrotizing palupalu maʻi maʻiʻaʻai ma muli o ke koʻohune ʻO Streptococcus pyogenes, i kapa ʻia i kekahi manawa ʻo "bacteria ʻai ʻiʻo ʻiʻo" a i ʻole strep.

Hoʻokumu ka maʻi necrotizing palupalu ke komo ka bacteria i ke kino, ma o ka ʻoki liʻiliʻi a i ʻole ka ʻānai ʻana. Hoʻomaka ka bacteria e ulu a hoʻokuʻu i nā mea ʻino (toxins) e pepehi i nā mea a pili i ke kahe o ke koko i kahi. Me ka strep ʻai ʻiʻo, hana pū ka bacteria i nā kemika e ālai i ka hiki i ke kino ke pane i ka meaola. I ka make ʻana o ke kino, komo ke koʻohuna i loko o ke koko a pāhola koke i loko o ke kino.

Pākuʻi ʻia paha nā ʻōuli:

• Liʻiliʻi, ʻulaʻula, puʻupuʻu ʻeha a puʻupuʻu paha i ka ʻili e hohola
• Kahi ʻeha e like me ka ʻehaʻeha a laila ulu a ulu wikiwiki, i kekahi manawa ma lalo o hoʻokahi hola
• Eʻeleʻele a pouli ke kikowaena a laila ʻeleʻele a make ke kino
• E haki paha ka ʻili a hoʻoheheʻe ka wai

Hiki i nā ʻōuli ʻē aʻe ke:

• Maʻi manaʻo
• Fiva
• Hoʻoulu
• ʻO Chills
• Nusea
• Puʻupuʻu
• Nawaliwali
• Pāhaʻi

Hiki paha i ka mea mālama ola ke hōʻoia i kēia ʻano ma ka nānā ʻana i kou ʻili. A i ʻole, ʻike ʻia ke ʻano i kahi lumi hana e kahi kauka.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Kukuna ultrasound
• X-ray a i ʻole CT scan
• Nā hoʻāʻo koko
• ʻO ka moʻomeheu koko e nānā i ka maʻi bacteria
• ʻO kahi ʻoki o ka ʻili e ʻike ai inā aia ka pus
  
• ʻO ka biopsy ʻili a me ka moʻomeheu

Pono pono ka mālama ʻana i kēia manawa no ka pale ʻana i ka make. E noho paha ʻoe i ka haukapila. Hoʻolālā pū kekahi:

• Hāʻawi ʻia nā antibiotic ikaika ma o ke aa (IV)
• ʻO ke kīʻaha e hoʻokahe i ka ʻeha a hemo i nāʻiʻo make
• ʻO nā lāʻau lapaʻau kūikawā i kapa ʻia nā immunoglobulins donor (antibodies) e kōkua i ke kaua ʻana i ka maʻi i kekahi mau hihia

Hiki i nā mālama ʻē aʻe ke:

• Hoʻopili ka ʻili ma hope o ka hele ʻana o ka maʻi e kōkua i kou ʻili e hoʻōla a maikaʻi ke nānā aku
• Hoʻonui inā hoʻolaha ka maʻi ma o ka lima a me ka wāwae
• Haneri pākēneka oxygen ma ke kiʻekiʻe kiʻekiʻe (hyperbaric oxygen therapy) no kekahi ʻano o nā maʻi koʻohune

Maikaʻi kāu hilinaʻi ʻana:

• ʻO kou olakino holoʻokoʻa (keu hoʻi inā he diabetes ʻoe)
• Pehea ka wikiwiki o kāu ʻike ʻia a me ka wikiwiki i loaʻa ai iā ʻoe ka lāʻau
• Ke ʻano o nā koʻohune e hoʻoulu ana i ka maʻi
• Pehea ka laha koke ʻana o ka maʻi
• Pehea ka maikaʻi o ka mālama ʻana

Hoʻomaopopo pinepine kēia maʻi i ka scarring a me ka ʻino deformity.

Hiki wawe ka make me ka ʻole o ka lāʻau kūpono.

Nā pilikia i hiki ke hopena ʻia mai kēia ʻano:

• Pālahalaha ka maʻi i loko o ke kino, e hōʻeha ana i ka maʻi koko (sepsis), a he mea make ia
• Scarring a me ka disfigurement
• Lilo o kou hiki ke hoʻohana i ka lima a i ka wāwae
• Make

He koʻikoʻi kēia maʻi a hoʻoweliweli paha i ke ola. Kāhea koke aku i kāu mea hāʻawi inā loaʻa nā ʻōuli o ka maʻi ma kahi ʻeha o ka ʻili, me:

• Kahe o ka pus a i ʻole ke koko
• Fiva
• ʻEha
• ʻUlaʻula
• ʻŌhū

E hoʻomaʻemaʻe mau i ka ʻili ma hope o kahi ʻoki, ʻoki, a i ʻole ʻeha ʻeha ʻē aʻe.

Necrotizing fasciitis; Fasciitis - nerotizing; Huakōʻai ʻai ʻiʻo; Gangreneʻa palupalu; Gangrene - nā mea palupalu

Abbas M, Uçkay I, Ferry T, Hakko E, Pittet D. Nā maʻi maʻi palupalu koʻikoʻi. I: Bersten AD, Handy JM, nā huahana. Manuahi Manaʻo Kākoʻo Oh. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 72.

Fitzpatrick JE, High WA, Kyle WL. Nā maʻi ʻili nehrototic a me ulcerative. I: Fitzpatrick JE, High WA, Kyle WL, eds. ʻO Dermatology Care Urgent: Diagnosis. Piladelapia, PA: Elsevier; 2018: chap 14.

Pasternack MS, Swartz MN. Cellulitis, frotciitis necrotizing, a me nā maʻi maʻi subcutaneus. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier Saunders; 2020: chap 93.

Stevens DL, Bisno AL, Chambers HF, et al. Nā kulekele hoʻomaʻamaʻa no ka ʻike a me ka mālama ʻana i nā ʻili a me nā maʻi pahee: 2014 hōʻano hou ʻia e ka Infectious Diseases Society of America Maʻi maʻi maʻi Dis. 2015; 60 (9): 1448. Hewa o ka hana ma ka ʻōlelo ʻatikala]. Maʻi maʻi maʻi Dis. 2014; 59 (2): e10-e52. PMID: 24973422 pubmed.ncbi.nlm.nih.gov/24973422.